The process of implementing a new baby-friendly hospital initiative for nurses: a grounded theory study

Maternity nursing practice is changing across Canada with the movement toward becoming “baby friendly.” The World Health Organization (WHO) recommends the Baby-Friendly Hospital Initiative (BFHI) as a standard of care in hospitals worldwide. Very little research has been conducted with nurses to explore the impact of the initiative on nursing practice. The purpose of this study, therefore, was to examine the process of implementing the BFHI for nurses. The study was carried out using Corbin and Strauss’s method of grounded theory. Theoretical sampling was employed, which resulted in recruiting and interviewing 13 registered nurses whose area of employment included neonatal intensive care, postpartum, and labour and delivery. The data analysis revealed a central category of resisting the BFHI. All of the nurses disagreed with some of the 10 steps to becoming a baby-friendly hospital as outlined by the WHO. Participants questioned the science and safety of aspects of the BFHI. Also, participants indicated that the implementation of this program did not substantially change their nursing practice. They empathized with new mothers and anticipated being collectively reprimanded by management should they not follow the initiative. Five conditions influenced their responses to the initiative, which were (a) an awareness of a pro-breastfeeding culture, (b) imposition of the BFHI, (c) knowledge of the health benefits of breastfeeding, (d) experiential knowledge of infant feeding, and (e) the belief in the autonomy of mothers to decide about infant feeding. The identified outcomes were moral distress and division between nurses. The study findings could guide decision making concerning the implementation of the BFHI.

Study protocol of European Fans in Training (EuroFIT) : a four-country randomised controlled trial of a lifestyle program for men delivered in elite football clubs

Funding The EuroFIT study is funded by the European Union’s Seventh Framework Program for research technological development and demonstration under Grant Agreement no: 602170. The Health Services Research Unit, University of Aberdeen, is core funded by the Chief Scientist Office of the Scottish Government Health Directorates.

Ethnic differences in grains consumption and their contribution to intake of B-vitamins: results of the Multiethnic Cohort Study

Background: Research indicates that a diet rich in whole grains may reduce the risk of prevalent chronic diseases, including cardiovascular disease, diabetes, and some cancers, and that risk for these diseases varies by ethnicity. The objective of the current study was to identify major dietary sources of grains and describe their contribution to B vitamins in five ethnic groups. Methods. A cross-sectional mail survey was used to collect data from participants in the Multiethnic Cohort Study in Hawaii and Los Angeles County, United States, from 1993 to 1996. Dietary intake data collected using a quantitative food frequency questionnaire was available for 186,916 participants representing five ethnic groups (African American, Latino, Japanese American, Native Hawaiian and Caucasian) aged 45-75 years. The top sources of grain foods were determined, and their contribution to thiamin, riboflavin, niacin, vitamin B6, and folic acid intakes were analyzed. Results: The top source of whole grains was whole wheat/rye bread for all ethnic-sex groups, followed by popcorn and cooked cereals, except for Native Hawaiian men and Japanese Americans, for whom brown/wild rice was the second top source; major contributors of refined grains were white rice and white bread, except for Latinos. Refined grain foods contributed more to grain consumption (27.1-55.6%) than whole grain foods (7.4-30.8%) among all ethnic-sex groups, except African American women. Grain foods made an important contribution to the intakes of thiamin (30.2-45.9%), riboflavin (23.1-29.2%), niacin (27.1-35.8%), vitamin B6 (22.9-27.5%), and folic acid (23.3-27.7%). Conclusions: This is the first study to document consumption of different grain sources and their contribution to B vitamins in five ethnic groups in the U.S. Findings can be used to assess unhealthful food choices, to guide dietary recommendations, and to help reduce risk of chronic diseases in these populations.

The food choice at work study: effectiveness of complex workplace dietary interventions on dietary behaviours and diet-related disease risk - study protocol for a clustered controlled trial

Background: Dietary behaviour interventions have the potential to reduce diet-related disease. Ample opportunity exists to implement these interventions in the workplace. The overall aim is to assess the effectiveness and cost-effectiveness of complex dietary interventions focused on environmental dietary modification alone or in combination with nutrition education in large manufacturing workplace settings. Methods/design: A clustered controlled trial involving four large multinational manufacturing workplaces in Cork will be conducted. The complex intervention design has been developed using the Medical Research Council's framework and the National Institute for Health and Clinical Excellence (NICE) guidelines and will be reported using the TREND statement for the transparent reporting of evaluations with non-randomized designs. It will draw on a soft paternalistic 'nudge' theoretical perspective. It will draw on a soft paternalistic "nudge" theoretical perspective. Nutrition education will include three elements: group presentations, individual nutrition consultations and detailed nutrition information. Environmental dietary modification will consist of five elements: (a) restriction of fat, saturated fat, sugar and salt, (b) increase in fibre, fruit and vegetables, (c) price discounts for whole fresh fruit, (d) strategic positioning of healthier alternatives and (e) portion size control. No intervention will be offered in workplace A (control). Workplace B will receive nutrition education. Workplace C will receive nutrition education and environmental dietary modification. Workplace D will receive environmental dietary modification alone. A total of 448 participants aged 18 to 64 years will be selected randomly. All permanent, full-time employees, purchasing at least one main meal in the workplace daily, will be eligible. Changes in dietary behaviours, nutrition knowledge, health status with measurements obtained at baseline and at intervals of 3 to 4 months, 7 to 9 months and 13 to 16 months will be recorded. A process evaluation and cost-effectiveness economic evaluation will be undertaken. Discussion: A 'Food Choice at Work' toolbox (concise teaching kit to replicate the intervention) will be developed to inform and guide future researchers, workplace stakeholders, policy makers and the food industry. Trial registration: Current Controlled Trials, ISRCTN35108237.

X-Ray Diffraction Study of Boron Produced by Pyrolysis of Boron Tribromide

The goal of this research was to determine the composition of boron deposits produced by pyrolysis of boron tribromide, and to use the results to (a) determine the experimental conditions (reaction temperature, etc.) necessary to produce alpha-rhombohedral boron and (b) guide the development/refinement of the pyrolysis experiments such that large, high purity crystals of alpha-rhombohedral boron can be produced with consistency. Developing a method for producing large, high purity alpha-rhombohedral boron crystals is of interest because such crystals could potentially be used to achieve an alpha-rhombohedral boron based neutron detector design (a solid-state detector) that could serve as an alternative to existing neutron detector technologies. The supply of neutron detectors in the United States has been hampered for a number of years due to the current shortage of helium-3 (a gas used in many existing neutron detector technologies); the development of alternative neutron detector technology such as an alpha-rhombohedral boron based detector would help provide a more sustainable supply of neutron detectors in this country. In addition, the prospect/concept of an alpha-rhombohedral boron based neutron detector is attractive because it offers the possibility of achieving a design that is smaller, longer life, less power consuming, and potentially more sensitive than existing neutron detectors. The main difficulty associated with creating an alpha-rhombohedral boron based neutron detector is that producing large, high purity crystals of alpha-rhombohedral boron is extremely challenging. Past researchers have successfully made alpha-rhombohedral boron via a number of methods, but no one has developed a method for consistently producing large, high purity crystals. Alpha-rhombohedral boron is difficult to make because it is only stable at temperatures below around 1100-1200 °C, its formation is very sensitive to impurities, and the conditions necessary for its formation are not fully understood or agreed upon in the literature. In this research, the method of pyrolysis of boron tribromide (hydrogen reduction of boron tribromide) was used to deposit boron on a tantalum filament. The goal was to refine this method, or potentially use it in combination with a second method (amorphous boron crystallization), to the point where it is possible to grow large, high purity alpha-rhombohedral boron crystals with consistency. A pyrolysis apparatus was designed and built, and a number of trials were run to determine the conditions (reaction temperature, etc.) necessary for alpha-rhombohedral boron production. This work was focused on the x-ray diffraction analysis of the boron deposits; x-ray diffraction was performed on a number of samples to determine the types of boron (and other compounds) formed in each trial and to guide the choices of test conditions for subsequent trials. It was found that at low reaction temperatures (in the range of around 830-950 °C), amorphous boron was the primary form of boron produced. Reaction temperatures in the range of around 950-1000 °C yielded various combinations of crystalline boron and amorphous boron. In the first trial performed at a temperature of 950 °C, a mix of amorphous boron and alpha-rhombohedral boron was formed. Using a scanning electron microscope, it was possible to see small alpha-rhombohedral boron crystals (on the order of ~1 micron in size) embedded in the surface of the deposit. In subsequent trials carried out at reaction temperatures in the range of 950 °C – 1000 °C, it was found that various combinations of alpha-rhombohedral boron, beta-rhombohedral boron, and amorphous boron were produced; the results tended to be unpredictable (alpha-rhombohedral boron was not produced in every trial), and the factors leading to success/failure were difficult to pinpoint. These results illustrate how sensitive of a process producing alpha-rhombohedral boron can be, and indicate that further improvements to the test apparatus and test conditions (for example, higher purity/cleanliness) may be necessary to optimize the boron deposition. Although alpha-rhombohedral boron crystals of large size were not achieved, this research was successful in (a) developing a pyrolysis apparatus and test procedure that can serve as a platform for future testing, (b) determining reaction temperatures at which alpha-rhombohedral boron can form, and (c) developing a consistent process for analyzing the boron deposits and determining their composition. Further experimentation is necessary to achieve a pyrolysis apparatus and test procedure that can yield large alpha-rhombohedral boron crystals with consistency.

'Lines of flight': digital musical instruments, inclusive music bands, meaningful engagement in music-making and learning

In this study I examine the development of three inclusive music bands in Cork city. Derived from Jellison’s research on inclusive music education, inclusive music bands involve students with disabilities coming together with typically developing peers to make and learn music that is meaningful (Jellison, 2012). As part of this study, I established three inclusive music bands to address the lack of inclusive music making and learning experiences in Cork city. Each of these bands evolved and adapted in order to be socio-culturally relevant within formal and informal settings: Circles (community education band), Till 4 (secondary school band) and Mish Mash (third level and community band). I integrated Digital Musical Instruments into the three bands, in order to ensure access to music making and learning for band members with profound physical disabilities. Digital Musical Instruments are electronic music devices that facilitate active music making with minimal movement. This is the first study in Ireland to examine the experiences of inclusive music making and learning using Digital Musical Instruments. I propose that the integration of Digital Musical Instruments into inclusive music bands has the potential to further the equality and social justice agenda in music education in Ireland. In this study, I employed qualitative research methodology, incorporating participatory action research methodology and case study design. In this thesis I reveal the experiences of being involved in an inclusive music band in Cork city. I particularly focus on examining whether the use of this technology enhances meaningful music making and learning experiences for members with disabilities within inclusive environments. To both inform and understand the person centered and adaptable nature of these inclusive bands, I draw theoretical insights from Sen’s Capabilities Approach and Deleuze and Guatarri’s Rhizome Theory. Supported by descriptive narrative from research participants and an indepth examination of literature, I discover the optimum conditions and associated challenges of inclusive music practice in Cork city.

Resonances: Noise and Contemporary Music

Noise seems to stand for a lack of aesthetic grace, to alienate or distract rather than enrapture. And yet the drones of psychedelia, the racket of garage rock and punk, the thudding of rave, the feedback of shoegaze and post-rock, the bombast of thrash and metal, the clatter of jungle and the stuttering of electronica, together with notable examples of avant-garde noise art, have all found a place in the history of contemporary musics, and are recognised as representing key evolutionary moments. Noise therefore is the untold story of contemporary popular music, and in a critical exploration of noise lies the possibility of a new narrative – one that is wide-ranging, connects the popular to the underground and avant-garde, fully posits the studio as a musical instrument, and demands new critical and theoretical paradigms of those seeking to write about music. Resonances is a compelling collection of new essays by scholars, writers and musicians – all seeking to explore and enlighten this field of study.

‘Never Let Me Down Again’1: Loyal customer attitudes towards ticket distribution channels for live music events: a netnographic exploration of the US leg of the Depeche Mode 2005–2006 World Tour

Ticket distribution channels for live music events have been revolutionised through the increased take-up of internet technologies, and the music supply-chain has evolved into a multi-channel value network. The assumption that this creates increased consumer autonomy and improved service quality is explored here through a case-study of the ticket pre-sale for the US leg of the Depeche Mode 2005–06 World Tour, which utilises an innovative virtual channel strategy, promoted as a service to loyal fans. A multi-method analysis, adopting Kozinets' (2002) Kozinets, R. V. 2002. The field behind the screen: using netnography for marketing research in online communities. Journal of Marketing Research, 39: 61–72. [CrossRef], [Web of Science ®] netnography methodology, is employed to map responses of the band's serious fan base on an internet message board (IMB) throughout the tour pre-sale. The analysis focuses on concerns of pricing, ethics, scope of the offer, use of technology, service quality and perceived brand performance fit of channel partners. Findings indicate that fans behaviour is unpredictable in response to channel partners' performance, and that such offers need careful management to avoid alienation of loyal consumers.

A look into diversity in the radio and music industry in Spain

UNESCO’s approval of the Convention on the Protection and Promotion of the Diversity of Cultural Expressions (UNESCO, 2005) has been an important element in catalyzing any attempt to measure the diversity of cultural industries (UIS, 2011). Within this framework, this article analyzes the relations between the music and radio industries in Spain from a critical perspective through the analysis of available data on recorded music offer and consumption (sales lists, radio-formula lists, the characteristics of the phonographic and radio markets) in different key moments due to the emergence of new formats and devices (CDS, Mp3, Internet).The main goal of this work is to study the evolution of the Spanish record market in terms of diversity from the end of the 1970s to the present, through the study of radio music hits lists and, the business structure of the phonographic and radio sectors, and phonograms top sales

Influences and advice of theatrical consumption. A study about the effect of the theatre critics and other instances of evaluation in the habits of theatre attendance

This article analyses the influence that different criticism stages of proceedings exert in the habits of theatre attendance. The study is based on the survey carried out specifically for this research in which 210 people, who attended a theatrical representation, were interviewed in three different theatres in the city of Valencia. The study has revealed the mouth to mouth importance in the decision of attending the theatre and its stronger influence on the audiences who less frequently go to theatrical representations. The results obtained have also made clear the existence of a narrow relation between the advice effect of the theatre critics and the patterns of attendance to the theatre, just like its bigger influence between theatres with commercial orientation and those which are addressed to the broad audiences.

Music therapy, in tuning at the end of life

In this article music therapy is presented as a helpful tool to support the persons (and their relatives) living at the end of their life and, also, as a non pharmacological and complementary therapy in an integral and holistic medicine. What we report here comes from the direct experience, nourished after many years of interventions and reflections in oncology and palliative care units. We’re talking about silence, music, therapy, models and techniques. We will read and feel therapeutic sessions… but above all, we’re talking about life, conscience and love.

Expert players accurately detect an opponent's movement intentions through sound alone

Sounds offer a rich source of information about events taking place in our physical and social environment. However, outside the domains of speech and music, little is known about whether humans can recognize and act upon the intentions of another agent’s actions detected through auditory information alone. In this study we assessed whether intention can be inferred from the sound an action makes, and in turn, whether this information can be used to prospectively guide movement. In two experiments experienced and novice basketball players had to virtually intercept an attacker by listening to audio recordings of that player’s movements. In the first experiment participants had to move a slider, while in the second one their body, to block the perceived passage of the attacker as they would in a real basketball game. Combinations of deceptive and non-deceptive movements were used to see if novice and/or experienced listeners could perceive the attacker’s intentions through sound alone. We showed that basketball players were able to more accurately predict final running direction compared to non-players, particularly in the second experiment when the interceptive action was more basketball specific. We suggest that athletes present better action anticipation by being able to pick up and use the relevant kinematic features of deceptive movement from event-related sounds alone. This result suggests that action intention can be perceived through the sound a movement makes and that the ability to determine another person’s action intention from the information conveyed through sound is honed through practice.

A 'before and after' study of nursing students' self-assessed competence in identifying the needs of older patients in hospital using an educational workbook.

Background: A core component of nurse education is clinical practice in order to support the development of clinical skills and competence. Assessment and measurement of the clinical competence of nursing students is important to gauge their professional development and educational needs.

Aim: To evaluate the impact of an Older Persons’ Assessment Educational Workbook (OPAEW) and explore second year nursing students’ competence and their opinions and use of the workbook.

Methods: A ‘before and after’ pre-experimental design was undertaken with n=6 second year nursing students. Outcome measures were the Nursing Competencies Questionnaire and the Self-efficacy in Clinical Performance Scale. Content analysis of workbooks and a survey (n=5) of opinions regarding the workbook was undertaken.

Findings: Pre and post test results for the study (n=5) were tested to determine if there was a relationship between changes in the NCQ and SECP repeated measures and use of an OPAEW. Testing identified evidence of a statistically significant difference for both SECP measures (SECP28 p=0.043; SECP7 p=0.042), with no clear statistical evidence of a difference for the NCQ (p=0.08). A weak negative association (NCQ ρ=-0.600 p=0.285; SECP28 ρ=-0.300 p=0.624; SECP7 ρ=-0.205 p=0.741), was found indicating that those participants who scored the lowest scores at the start of the study, benefited most from the workbook.

Content analysis of the OPAEW (n=5) found that 3 of the 5 participants completed all components of the workbook, with a mean of 1051 words used (SD 281.8). Through the survey (n=5) students reported the workbook as a useful guide when undertaking a patient assessment.

Conclusions: The OPAEW showed potential as an intervention to support the development of nursing students’ competence in older person assessment skills.

A 'before and after' study of nursing students' self-assessed competence in identifying the needs of older patients in hospital using an educational workbook.

Background: A core component of nurse education is clinical practice in order to support the development of clinical skills and competence. Assessment and measurement of the clinical competence of nursing students is important to gauge their professional development and educational needs.

Aim: To evaluate the impact of an Older Persons’ Assessment Educational Workbook (OPAEW) and explore second year nursing students’ competence and their opinions and use of the workbook.

Methods: A ‘before and after’ pre-experimental design was undertaken with n=6 second year nursing students. Outcome measures were the Nursing Competencies Questionnaire and the Self-efficacy in Clinical Performance Scale. Content analysis of workbooks and a survey (n=5) of opinions regarding the workbook was undertaken.

Findings: Pre and post test results for the study (n=5) were tested to determine if there was a relationship between changes in the NCQ and SECP repeated measures and use of an OPAEW. Testing identified evidence of a statistically significant difference for both SECP measures (SECP28 p=0.043; SECP7 p=0.042), with no clear statistical evidence of a difference for the NCQ (p=0.08). A weak negative association (NCQ ρ=-0.600 p=0.285; SECP28 ρ=-0.300 p=0.624; SECP7 ρ=-0.205 p=0.741), was found indicating that those participants who scored the lowest scores at the start of the study, benefited most from the workbook.

Content analysis of the OPAEW (n=5) found that 3 of the 5 participants completed all components of the workbook, with a mean of 1051 words used (SD 281.8). Through the survey (n=5) students reported the workbook as a useful guide when undertaking a patient assessment.

Conclusions: The OPAEW showed potential as an intervention to support the development of nursing students’ competence in older person assessment skills.

Music Learning Networks: Supporting the Music Learning of Adolescents

Thesis (Ph.D.)--University of Washington, 2016-08